Examination of the Cardiovascular System: The child should be undressed appropriately to the waist. In the older child, the examination easily performed with the patient sitting over the edge of the bed or even on a chair. Preferably, examine the younger child on the parent’s lap. Removing a toddler from his parents is less likely to yield good clinical signs and more likely to yield a screaming child. For examination of femoral pulses, the child should be in the supine position.

Examination of the Cardiovascular System NB: This essay is a result of a test that we gave our recruits. If we want our professional writers to handle your assignment, kindly ORDER NOW below.

Warm your hands by rubbing them against each other.

STEPS OF THE TASK

You should use the middle three fingers of your dominant hand to palpate the pulses against the underlying bone. The finger tips are used for palpation as they have maximum sensitivity.

While palpating, the artery is stabilized by the proximal and distal fingers and the thrust of the pulse is felt by the middle finger. Partial occlusion of the artery by the distal finger improves the thrust of the pulse wave on the middle finger.

Palpate all the pulses listed below first on the right and then on the left side. Always compare the respective pulses on both sides except the carotids. In case of carotids, palpitating both sides can induce cerebral ischemia and can cause the patient to faint.

Carotid (don’t palpate both sides simultaneously) – Palpated at the level of thyroid cartilage along the medial border of the sternomastoid muscle either with finger tips or thumb (left thumb for the right side and vice versa)

Brachial – Palpated with the elbow flexed along the medial aspect of the lower end of the arm

Radial – felt at the lower end of the radius on the anterior aspect of the wrist, medial to the styloid process with the patient’s forearm slightly pronated and wrist semiflexed

Femoral (DO NOT FORGET FEMORALS) – felt in the middle of the groin with the leg slightly flexed and abducted and foot externally rotated.

Dorsalis pedis – can be felt on the dorsum of the foot lateral to the extensor hallucis tendon in the middle third of the foot

Posterior tibial – felt posterior to the medial malleolus and anterior to the Achilles tendon.

For assessing the pulse rate, use brachial pulse in an infant or toddler and radial pulse in older children

While counting the pulse rate, count for 15 seconds and multiply by 4. But tell the examiner that ideally, you would like to count for one minute. However, if the pulse is irregular, then count for one full minute and also count the heart rate by auscultation.

Rhythm – while looking for the rhythm, one looks for the gap between the pulse waves and comment on their regularity.

Volume

This is a highly subjective sign. It describes the thrust (expansion) of the pulse wave and reflects the pulse pressure.

If high volume, always check for collapsing nature. (Hold the right forearm of the patient by your hand in such a way as the radial artery is under the head of the metacarpals of our hand. Lift the patient’s entire upper limb vertically by 90ï‚°and feel for the sudden and exaggerated rise and fall of the pulsations of radial artery.)

Character – This describes the form of the wave and various types are decided by the rise, peak and waning of the wave. It is best appreciated in carotids.

Radio femoral delay (femoral pulse appears following a time delay after radial – suggests coarctation of aorta)